3) A demand for additional resources (such as counseling) is needed to resolve the event / situation.

Stage 4 of Crisis Development:

4) Referral may be required to resolve major personality disorganization.

Summary of Crisis:

Crisis is a perception or experiencing of an event or situation as an intolerable difficulty that exceeds the person's current resources and coping mechanisms. Unless the person obtains relief, the crisis has the potential to cause severe affective, behavioral and cognitive malfuntioning.

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Characterisitcs of a crisis:

The nature of crisis is such that it contains both danger and opportunity.

Danger, because it can overwhelm and cause serious pathology, including homicide and suicide.

Opportunity, because the pain it induces causes the person to seek help.

Crisis can lead to self growth and self realization if the person takes advantage of the ooportunity.

Various reactions to a crisis:

Some cope effectively and develops strength from the experience.

Some appear to survive, but block the hurtful effect from awareness

Some break down psychologically and need further assistance.

Difference between PTSD and Transcrisis state:

Key Differentiating element:

Transcrisis states are residual andrecurrentand always present to some degree.

Causes of Transcrisis states:

Trauma

Personality traits

Substance abuse

Psychosis

Chronic environmental stressors.

PTSD:

A person suffering from PTSD may be in a transcrisis state, but not all people in a transcrisis state suffer from PTSD.

Gerry's CISD (Critical Incidence stress debriefing):

Facts

Feelings

Future

Resolve (What can we do to resolve the problem?)

Characteristics of People in Transcrisis States:

Anxiety and Personality Disorders (as per DSM - IV - TR )

Chronic problematic thinking, feeling and acting

Uncontrollable tempers, behaviours. action

Those with psychoses who quit their meds

Summary of people in transcrisis states:

All people in a transcrisis state are generally capable of functioning at some minimum level. Nevertheless, they are always at risk, and any single, small, added stressor may tip the balance and send them into crisis.

Assessment of people in transcrisis states:

When we assess individuals in crisis, our emphasis is not only on the current clinical / diagnostic state of the individual, but also, and as importantly, on the repetitious cycle of problems and the historical precursors that may have caused the crisis to arise.

Transcrisis states and therapeutic intervention:

Being aware that someone is operating in a transcrisis state also gives us important information regarding the kind and degree of therapeutic intervention to provide, in both the short and the long term.

Transcrisis points:

Transcrisis points can be seen as benchmarks that are crucial to progressive stages of positive therapeutic growth.

Occur frequently in transcrisis states within the therapeutic intervention.

They are generally marked by the client coming to grips with new developmental stages or other dimensions of the problem.

Transcrisis points:

Do not occur in regular, predictable, linear progression, ex. battered spouse may go through multiple transcrisis points in talking to a crisis worker before making the decision to leave the battering relationship.

Transcrisis points of severity nevertheless occurs again with geographic move, and hunting for a job. Overwhelming disequilibrium follows.

Transcrisis points:

It is at these transcrisis points (of overwhelming diequilibrium) that standard therapeutic strategies and techniques are suspended, and the therapist must operate in a crisis intervention mode.

Transcrisis points:

Can be seen as benchmarks that are crucial to progressive stages of positive therapeutic growth.